European Child & Adolescent Psychiatry

https://doi.org/10.1007/s00787-019-01306-8

ORIGINAL CONTRIBUTION

The interplay between self‑regulation and affectivity in binge eating

among adolescents
Eva Van Malderen1   · Lien Goossens1 · Sandra Verbeken1 · Elisa Boelens1 · Eva Kemps2

Received: 20 December 2018 / Accepted: 1 March 2019

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Abstract
Binge eating among adolescents is associated with negative developmental outcomes. From a cognitive perspective, the role
of impaired self-regulation is increasingly emphasized as an underlying factor in binge eating, whereas the affect regulation
model proposes that affectivity is a key factor in explaining binge eating. Studies combining both perspectives are scarce,
but necessary to add to the understanding of this pathological eating behavior. Therefore, the aim of the current study was
to investigate unique and joint contributions of both factors in understanding binge eating among adolescents. Participants
were 301 adolescents (10–17 years; 67.2% girls; Mage = 13.46 years; SD = 1.99) from the general community. Adolescents
self-reported on different types of binge eating episodes (loss of control over eating in general, objective and subjective binge
eating in particular), self-regulation (general self-regulation and inhibitory control) and affectivity (positive and negative).
The parents were questioned about their children’s self-regulatory capacities. Results revealed main effects of self-regulatory
capacities (adolescent report) and negative affectivity in predicting objective binge eating. In addition, negative affectivity
interacted with self-regulation (parent report) to predict objective binge eating, whereas positive affectivity interacted with
self-regulation (adolescent report) to predict subjective binge eating. No significant effects were found for loss of control
over eating specifically. Both self-regulation and affectivity each make unique as well as joint contributions to binge eating
among adolescents, with results differing across types of binge eating episodes and informants. Theoretical and practical
implications are discussed.

Keywords  Adolescents · Binge eating · Self-regulation · Affectivity

Introduction objective and subjective binge eating episodes. While both

Binge eating
Recent prevalence rates suggest that worldwide approxi-
mately one third of adolescents report binge eating episodes
[1–4]. Over the past decade, researchers have found that the
subjective feeling of loss of control while eating [5] can
be considered the key feature of binge eating [6–8]. How-
ever, based on the amount of food that is eaten during a
binge eating episode, a distinction has been made between
* Eva Van Malderen
eva.vanmalderen@ugent.be
1
Department of Developmental, Personality and Social
Psychology, Ghent University, Henri Dunantlaan 2,
9000 Ghent, Belgium
2
School of Psychology, Flinders University, GPO Box 2100,
Adelaide, SA 5001, Australia
types are characterized by loss of control over eating (i.e.,
LOC), during an objective binge eating episode (i.e., OBE),
an objectively large amount of food is consumed, whereas
during a subjective binge eating episode (i.e., SBE) [9], the
amount of food consumed is considered to be large accord-
ing to the individual but not to others. Importantly, these
different types of binge eating episodes have been shown to
be clinically different constructs in adolescents and are dif-
ferentially associated with clinical features such as depres-
sive symptoms. For example, Fitzsimmons‐Craft et al. [10]
and Goldschmidt et al. [11] found that OBE may be indica-
tive for eating-related distress, whereas SBE may reflect
more generalized distress related to both eating and mood
psychopathology such as depressive symptoms. In addition,
Goossens, Soenens, and Braet [12] found that the combined
presence of OBE and SBE was associated with more mood-
related pathology. Despite these findings, previous stud-
ies have often focused on either LOC and/or OBE as the

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primary outcome variable, whereas SBE has largely been
ignored. In addition, while these results seem to indicate that
the binge eating episodes differ with regard to mood-related
pathology, it tells little about whether temperament-based
affectivity dimensions (i.e., traits) may add to the explana-
tion of different types of binge eating.
Overall, binge eating episodes are associated with a
wide range of physical (e.g., weight/fat gain, obesity) and
psychosocial (e.g., depressive symptoms, low self-esteem)
problems [13, 14]. In addition, high comorbidity rates have
been reported between binge eating and other types of eat-
ing pathologies (e.g., restraint eating, food-related craving;
[15]). Moreover, longitudinal research has shown that binge
eating may be a precursor to clinical eating disorders (e.g.,
Boulimia Nervosa) or other types of psychopathology (e.g.,
addiction) [16]. Given the high prevalence rates of binge eat-
ing among adolescents and the many aversive and long-term
consequences, research into the factors that add to the under-
standing of this pathological eating behavior is necessary in
the context of prevention and early intervention. Over recent
years, efforts have been made to examine these underlying
factors in youth, but they remain to be fully understood (e.g.,
[2, 17–20]).
Binge eating and self‑regulation
Self-regulation can be defined as the regulation of and by
oneself to obtain long-term goals [21], and consists of dif-
ferent cognitive capacities such as working memory, cog-
nitive flexibility, inhibitory control, problem solving and
planning. It has been well established that difficulties with
self-regulation are a transdiagnostic risk factor for develop-
ing psychopathology [22]. As maintaining healthy eating
behavior requires a number of everyday self-regulatory skills
(e.g., deciding what to do when confronted with palatable
foods) and given the compulsive nature of binge eating [23],
the role of self-regulation and specifically inhibitory control
is increasingly emphasized in binge eating research. Empiri-
cal studies examining the relationship between inhibitory
control and binge eating in adults show mixed results. Some
studies have found evidence for impaired inhibitory con-
trol in adults who experience binge eating (e.g., [24–26]),
whereas others have not, but instead found impairments in
other aspects of self-regulation such as problem solving,
cognitive flexibility and working memory (e.g., [27, 28]).
Although self-regulation is still developing during adoles-
cence [4, 29], only limited studies have focused on inves-
tigating its role in binge eating among younger samples.
As in adult studies, findings have been inconclusive. For
example, Goldschmidt et al. [17] showed that obese children
(9–12 years old) who experience binge eating encountered
more problems with working memory compared to obese
children without binge eating and normal weight controls.
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European Child & Adolescent Psychiatry
In addition, Van Malderen et al. [2] found more overall self-
regulatory impairments among adolescents (10–17 years
old) who reported binge eating compared to those who did
not, but they did not find any group differences for inhibitory
control specifically. Despite this evidence for the underlying
role of self-regulation in binge eating, it remains difficult to
draw firm conclusions with respect to inhibitory control.
It is important to note that research regarding the role of
self-regulation in binge eating has been conducted rather
independently from other possible explanatory factors. How-
ever, it is assumed that problematic eating behavior such as
binge eating may not be explained by one single factor (e.g.,
self-regulation), but rather is the result of a combination of
multiple factors [30]. Therefore, an investigation of multiple
explanatory factors will be crucial to furthering our under-
standing of binge eating in youth.
Binge eating and affectivity
Another valuable research line in the binge eating domain
focuses on the possible role of affectivity in binge eating
among adolescents. Affectivity can be conceptualized as
the way people react to and interact with the environment,
therefore often being referred to as the reactive dimension of
temperament [31, 33]. This reactive dimension of tempera-
ment consists of two factors: (1) negative affectivity, which
can be described as the susceptibility to experience negative
feelings and distress and (2) positive affectivity, which can
be defined as the susceptibility to experience positive feel-
ings and joy [33]. Like self-regulation, negative affectivity
has been related to different kinds of psychopathology (e.g.,
[34, 35]). The affect regulation model proposes that high
levels of negative affectivity are a key factor in the develop-
ment and maintenance of binge eating [36–38]. In support,
negative affectivity has been found to be a robust risk factor
for binge eating in adults (e.g., [39–41]). In children and
adolescents, negative affectivity has been associated with
binge eating cross-sectionally, longitudinally and experi-
mentally (e.g., [42, 43]).
As negative and positive affectivity are two distinct tem-
peramental traits in which people can vary independently,
the literature on positive affectivity in adolescent psycho-
pathology has grown in recent years [44]. In the area of
depression in particular, low levels of positive affectivity
are considered to be a robust risk factor [45]; however, the
role of positive affectivity has also been acknowledged in
other types of psychopathology [46]. Although in the area
of eating problems, research on positive affectivity is still in
its infancy; some studies have demonstrated a role for this
affectivity dimension [38]. For example, Smyth et al. [47]
observed a decrease in positive affectivity in women with
eating disorders. Furthermore, a recent lab study showed
that a decrease in positive affectivity may cause body
European Child & Adolescent Psychiatry
dissatisfaction in early adolescence [48]. However, the role
of positive affectivity in binge eating among adolescents is
currently unknown and its examination may increase our
understanding of the contribution of affectivity to this patho-
logic eating behavior.
Binge eating, self‑regulation and affectivity
As self-regulatory processes and affectivity can influence
each other bi-directionally [49–51], researchers have shown
increasing interest in combining these factors in eating
pathology research. Within this line of research, negative
urgency (i.e., the tendency to act impulsively when dis-
tressed) has been found to play an important role in binge
eating (e.g., [38, 52]). However, because the construct of
negative urgency constitutes a combination of both self-
regulatory and affective processes, it is not possible to dis-
tinguish the unique and combined influences of these pro-
cesses. Thus, our understanding of the nature of the complex
interplay between these two factors in the context of binge
eating remains to be fully understood.
Therefore, over recent years, efforts have been made to
increase our understanding of both the unique and combined
influences of self-regulatory and affective processes on binge
eating; however, studies have mainly been conducted in adult
samples. Moreover, in these studies, only LOC or OBE epi-
sodes have been included as outcome variables, without
considering SBE. For example, both Racine et al. [53] and
Mason et al. [54] showed that adult women from the general
community who experience LOC or OBE could be charac-
terized by a combination of high impulsive behavior (i.e.,
low self-regulation) and high levels of negative affectivity.
In addition, in clinical populations, Manasse et al. [55] found
that adult women with binge eating disorder (i.e., at least
12 OBE episodes over the last 3 months according DSM-5)
[57] who experienced more inhibitory control difficulties
(i.e., low self-regulation), as well as higher levels of negative
affectivity, showed fewer benefits from treatment and any
treatment effects were slower to emerge. Furthermore, Leehr
et al. [57] found evidence for an interaction between high
impulsivity (i.e., low self-regulation) and impaired emotion
regulation capacities (reflected in high levels of negative
affectivity) in binge eating disorder among adults with the
use of neuroimaging techniques. It is important to empha-
size that all these studies focused exclusively on negative
affectivity without investigating the possible role of positive
affectivity. Smith et al. [58] did examine both affectivity
dimensions (negative and positive) in interaction with self-
regulation in predicting the probability of binge eating in an
adult community sample. They found significant interactions
between high levels of impulsive decision making (i.e., low
self-regulation) and high levels of both negative and posi-
tive affectivity in predicting the probability of experiencing
binge eating in adult women. To date, only one study has
explored the interaction between self-regulation and affectiv-
ity in an adolescent sample experiencing binge eating [59].
Results revealed that impaired inhibitory control in combi-
nation with high levels of negative affectivity were related
to greater overall severity of loss of control over eating [5].
To our knowledge, no study has yet examined both self-
regulation and affectivity (i.e., both negative and positive
affectivity) as explanatory factors in an adolescent sample
experiencing different types of binge eating (i.e., LOC, OBE
and SBE). However, knowledge gained from such a study
will add considerably to our understanding of the underly-
ing mechanisms of these types of binge eating episodes in
adolescence, because it can distinguish the unique and joint
contributions of both vulnerability factors. Accordingly,
outcomes may determine which (combination of) aspects
should be targeted in prevention and early intervention
programs.
Current study
Thus, the aim of the current study was to investigate the
unique and joint contributions of self-regulation and affec-
tivity in predicting binge eating among adolescents. Impor-
tantly, we included different types of binge eating (i.e., OBE,
SBE and LOC), as previous research has already shown that
differences between these types exist in terms of their associ-
ations with, for example, depressive symptoms [10–12]. To
this end, the study addressed two main research questions.1
First, it was examined whether self-regulatory capacities in
general, and inhibitory control in particular, and positive and
negative affectivity (i.e., unique effects) significantly con-
tribute to different types of binge eating. In line with previ-
ous research, it was hypothesized that greater self-regulatory
difficulties, as well as lower levels of positive affectivity and
higher levels of negative affectivity would independently
increase the likelihood of experiencing binge eating (e.g.,
[18, 43, 48]). Second, the current study investigated whether,
and how, both self-regulation and affectivity as vulnerability
factors interact to predict binge eating among adolescents
(i.e., joint effects). Based on recent research in adult samples
[53, 55], the combination of specifically poor self-regulatory
skills and high negative affectivity was predicted to produce
the most vulnerable profile for experiencing binge eating.
Because limited studies investigated the interaction between
self-regulation and positive affectivity in the explanation of
binge eating in adolescents, no a priori prediction was made
1
  Importantly, hypotheses for both research questions were based
on the available evidence in the current literature and consequently
included only for LOC or OBE as outcome variables. Including SBE
as a third outcome variable was exploratory in nature and therefore
no a priori predictions were made for this type of binge eating.
13

about this relationship. Similarly, since previous research is
inconclusive regarding the specific contribution of inhibitory
control in adolescent binge eating, no a priori predictions
were made about this aspect of self-regulation.
Method
Participants and procedure
Participants were 301 adolescents (10–17  years; 67.2%
girls; Mage = 13.46 years; SD = 1.99) and their parents from
the general community. Participants were recruited by
3rd year psychology students in the context of a practical
course. Each student was instructed to recruit two partici-
pants between 10 and 17 years old. All youngsters signed
an informed consent which provided information about the
study. As all participants were underage, their parents also
provided active consent for their own participation in the
study as well as that of their child. Data collection took place
in the participant’s home. Participants completed several
questionnaires on paper under supervision of the psychology
student. All students were carefully instructed and trained in
the data collection protocol, and contact details of the main
researcher were provided in case there were any questions
during the home visit. No incentives were provided for par-
ticipation. The procedure was approved by Ghent Univer-
sity’s Faculty Ethics Committee. The study is part of a larger
PhD project on binge eating among adolescents.
Materials
Binge eating
To assess binge eating, participants self-reported on this eat-
ing behavior using the ‘Children’s Eating Disorder Examina-
tion Questionnaire’ (ChEDE-Q; [60]). This questionnaire is
a Dutch translation and adaptation for children and adoles-
cents of the ‘Eating Disorder Examination Questionnaire’
(EDE-Q; [61]). It can be used in youngsters between 8 and
18 years of age and differentiates different forms of binge
eating. The questionnaire provides a measurement of objec-
tive binge eating episodes (OBE) as well as subjective binge
eating episodes [9]. Youngsters were categorized into one
or other group if they had at least one such episode over the
past month. Thus, a particular participant could be classified
into both the OBE and the SBE group. Moreover, as the feel-
ing of loss of control over eating [5] is inherent in both forms
of binge eating, this additional outcome measure can be
derived from the responses to the OBE and SBE questions.
More specifically, adolescents were categorized as experi-
encing LOC when they reported at least one OBE or SBE
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European Child & Adolescent Psychiatry
episode during the last month [20]. Previous research has
shown that the ChEDE-Q has good reliability and validity
for assessing eating pathology among adolescents [62, 63].
Self‑regulation
All participants and their parents filled out the ‘Behavior
Rating Inventory of Executive Function’ (BRIEF; [64, 65]).
The adolescent version of the BRIEF is suitable for children
and adolescents between the ages of 5 and 18 years and
consists of 68 items; the parent variant of the BRIEF has 75
items. Response options for items range from 1 (never) to
3 (often) in both versions of the questionnaire, with higher
scores reflecting greater self-regulatory difficulties. Both
versions of the questionnaire comprise two broad indices: a
‘Behavioral Regulation’ index and a ‘Metacognition’ index.
Each index is further subdivided into different underlying
subscales. In the current study, the ‘Behavioral Regulation’
index (BEH; e.g., ‘I/my child have/has trouble going from
one activity to another’) and the ‘Inhibition’ subscale [INH;
e.g., ‘I/my child interrupt(s) others’] were used to assess
self-regulatory skills. The BRIEF has been shown to have
good reliability and validity [66]. Internal consistency in the
current study was very good for both the adolescent version
(BEH-A: α = .86 and INH-A: α = .72) and the parent version
(BEH-P: α = .92 and INH-P: α = .80).
Affectivity
The trait version of the ‘Positive and Negative Affectivity
Schedule for Children’ (PANAS-C; [67]) was used to cap-
ture levels of positive and negative affectivity. This self-
report questionnaire consists of 30 items/emotions on a
5-point scale (ranging from 1 = not at all to 5 = a lot). Young-
sters indicate to which extent they usually experience each
emotion. The PANAS-C has two subscales, one for assess-
ing positive affectivity (PA; e.g., ‘happy’) and the other for
assessing negative affectivity (NA; e.g., ‘sad’). Each sub-
scale consists of 15 items. The PANAS-C has good validity
[67]. Internal consistency in the current study was very good
for both subscales (α = .87 for NA and α = .83 for PA).
Control variables
Age and gender were self-reported. In addition, each partici-
pant was measured and weighed at home using calibrated
instruments, from which an adjusted body mass index (km/
m2) was computed [(actual body mass index (kg/m2)/percen-
tile 50 of body mass index for age and gender) × 100] [68].
Percentile 50 of body mass index was calculated using Flem-
ish normative data which includes age and gender of the par-
ticipants [69]. As previous research has shown associations
between binge eating and age, gender and adjusted body
European Child & Adolescent Psychiatry
mass index [4, 13, 20], these demographics were included
as control variables in all analyses.
Statistical analysis
To investigate the research questions, a series of binary
logistic regression analyses were conducted using SPSS
(version 24.0). This type of analysis can predict the prob-
ability of a categorical outcome variable (i.e., LOC, OBE
or SBE) by different independent variables. Binge eating
was considered a categorical variable (0 = no episode, 1 = at
least one episode over the last month). Before running the
analyses, all continuous variables were centered around
their means [70]. All analyses were performed with the
same hierarchical structure of inputting variables. First, a
specific type of binge eating was entered as the categorical
dependent variable (either LOC, OBE or SBE). Second, age,
gender and adjusted body mass index were entered as control
variables in block 1. Third, self-regulation (either BEH-A,
INH-A, BEH-P or INH-P) and affectivity (NA and PA) were
entered as independent variables in block 2 (main effects).
Lastly, the interactions between self-regulation and affectiv-
ity (NA × self-regulation and PA × self-regulation) were
included in block 3. Given the different outcome measures
for self-regulation (four BRIEF outcomes), this procedure
resulted in four logistic regressions for each type of binge
eating. For the sake of brevity, only the full logistic regres-
sion model (including independent variables of all blocks)
was displayed in tables in the result section. Furthermore,
only significant main and interaction effects are interpreted
further, and when there was a significant interaction effect,
the remaining main effects were not interpreted further.
Significant interaction effects were interpreted using
PROCESS (model 1), an add-on utility in SPSS [71] to test
the conditional effect of the independent variable on the
dependent variable. To interpret the interaction effects, the
Johnson–Neyman technique was used [72]. This technique
reports the region of significance for the conditional inter-
action in terms of standard deviations from the mean of the
moderator, as well as the percentile of the distribution cor-
responding to that point. The significant interaction effects
were represented graphically showing the simple slopes for
the independent variable (self-regulation) at low (10th per-
centile) and high (90th percentile) levels of the moderator
(affectivity). For all analyses, p values ≤ .050 were consid-
ered statistically significant. Odds ratios (OR) were used as
the effect size measure in all analyses.
Results
Descriptive results
Adjusted body mass index of all participants ranged from
58.62 to 189.36 (M = 104.76, SD = 21.47). Of the sam-
ple, 9.8% of participants were classified as underweight
(adjusted body mass index ≤ 85), 74.7% as normal weight
(85 < adjusted body mass index < 120), 7.3% as overweight
(120 < adjusted body mass index < 140) and 8.2% as obese
(adjusted body mass index ≥ 140) [73]. According to the
ChEDE-Q [60], 31.5% of all adolescents reported having
had at least one episode of LOC over the past month (range
0–20). For OBE and SBE, the percentages were 18.2%
(range 0–16) and 19.1% (range 0–15), respectively. All
descriptive statistics (sample characteristics and correlations
between all variables of interest) can be found in Table 1.
The role of self‑regulation and affectivity in LOC
Results of all logistic regressions with self-regulation, affec-
tivity and their interaction in predicting the probability of
LOC revealed no significant main or interaction effects.
More specifically, no significant effects were found with NA
as the moderator in the relationship between self-regulation
and LOC, nor with PA as the moderator in this relationship.2
The role of self‑regulation and affectivity in OBE
Results of the logistic regressions with self-regulation,
affectivity and their interaction in predicting the probabil-
ity of OBE revealed significant main and interaction effects
(Table 2).
Model 1, including BEH-A, was significant with signifi-
cant main effects of BEH-A (p = .050, OR = 1.549) and NA
(p = .020, OR = 1.660). Specifically, high BEH-A and high
NA significantly increased the probability of OBE.
Model 2, including INH-A, was significant with a signifi-
cant main effect of NA (p = .005, OR = 1.724) such that high
NA significantly increased the probability of OBE.
Model 3, including BEH-P, was significant with a sig-
nificant main effect of NA (p = .005, OR = 1.743) as
well as a significant BEH-P x NA interaction (p = .035,
OR = .690). The interaction effect was significantly positive
for NA < −.200 SDs (44.58th percentile). Figure 1 shows
the interaction by way of simple slopes representing the
association between BEH-P and OBE at low (10th percen-
tile) and high (90th percentile) levels of NA. As shown, at
2
  For the sake of brevity, we have simply noted non-significant
results. Tables with an overview of the full results can be obtained
from the first author upon request.
13
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Table 1  Descriptive statistics M or % (SD) Min–max BEH-A INH-A BEH-P INH-P NA PA

Gender 67.2% female

Age 13.46 (1.99) 10–17 .180 .158** −.062** −.041 .120* −.223**
AdjBMI 104.76 (21.47) 58.62–189.36 .034 .092 .035 .113 .036 .098
LOC 31.5% LOC 0–20
OBE 18.2% OBE 0–16
SBE 19.12% SBE 0–15
BEH-A 48.15 (9.29) 31–81 1 .816** .315** .305** .484** −.297**
INH-A 19.89 (4.26) 12–43 1 .214** .371** .236** −.070
BEH-P 39.89 (8.97) 28–75 1 .791** .306** −.194**
INH-P 13.44 (3.22) 10–27 1 .134** −.092
NA 31.56 (8.99) 15–58 1 −.301**
PA 42.41 (7.33) 13–59 1

AdjBMI adjusted body mass index, LOC loss of control over eating, OBE objective binge eating, SBE sub-
jective binge eating, BEH-A BRIEF Behavioral Regulation index (adolescent report), INH-A BRIEF Inhi-
bition subscale (adolescent report), BEH-P BRIEF Behavioral Regulation index (parent report), INH-P
BRIEF Inhibition subscale (parent report), NA negative affectivity, PA positive affectivity
*p ≤ .050
**p ≤ .010
***p ≤ .001

low levels of NA (solid line), high scores on BEH-P signifi-
cantly increased the probability of OBE (b = .781, SE = .334,
p = .019). However, at high levels of NA (dashed line),
BEH-P did not significantly change the probability of OBE
(b = −.152, SE = .231, p = .512).
Model 4, including INH-P, was significant with a signifi-
cant main effect of NA (p = .004, OR = 1.737) whereby high
NA again significantly increased the probability of OBE.
The role of self‑regulation and affectivity in SBE
Results of the logistic regressions with self-regulation, affec-
tivity and their interaction in predicting the probability of
SBE revealed one significant interaction effect in model 1,
including BEH-A (Table 3).
Although the overall model itself was not significant, add-
ing the interaction terms to the model (block 3) significantly
improved the previous model which contained only the main
effects [χ2(2) = 6.108, p = .047]. BEH-A and PA significantly
interacted in predicting the probability of SBE (p = .030,
OR = 1.590). The interaction effect was significantly positive
for PA < −1.534 SDs (6.67th percentile) and significantly
negative for PA > 1.974 SDs (98.75th percentile). Figure 2
shows the interaction by way of simple slopes representing
the association between BEH-A and SBE at low (10th per-
centile) and high (90th percentile) levels of PA. As shown,
both at low levels of PA (solid line) and at high levels of PA
(dashed line), BEH-A did not significantly change the prob-
ability of SBE (b = −.629, SE = .335, p = .061 and b = .408,
SE = .267, p = .127, respectively). However, when inspecting
the regions of significance, it is clear that the influence of
PA is only statistically significant at very low and very high
levels of PA. More specifically, at very low levels of PA
(−4.01 < PA < −1.53), low BEH-A significantly increased
the probability of SBE (p < .05), whereas at very high lev-
els of PA (1.97 < PA < 2.26), high BEH-A significantly
increased the probability of SBE (p < .05).
Discussion
The aim of the current study was to further elucidate the
underlying mechanisms of binge eating among adolescents.
To this end, both the unique and the joint contributions of
self-regulation (general self-regulation and inhibitory con-
trol specifically) and affectivity (positive and negative) were
investigated in predicting the likelihood of experiencing dif-
ferent types of binge eating (i.e., LOC, OBE and SBE).
Unique and joint contributions of self‑regulation
and affectivity in binge eating
To address the first research question, the main effects of
self-regulation and affectivity were examined as explana-
tory factors for LOC, OBE and SBE. Results revealed
significant main effects of self-regulatory capacities and
negative affectivity, but only in predicting the probabil-
ity of OBE. Specifically, greater self-regulatory problems
(self-reported by the adolescent) and high negative affec-
tivity independently increased the likelihood of report-
ing OBE in youngsters. The independent contributions
of self-regulatory problems and high negative affectivity

13
 Table 2  Logistic regression analysis: self-regulation × affectivity in predicting the probability of OBE
Model ­1a Model ­2b Model ­3c Model ­4d
Wald χ2 B (SE) p Wald χ2 B (SE) p Wald χ2 B (SE) p Wald χ2 B (SE) p
European Child & Adolescent Psychiatry

Covariates
Gender .677 −.376 (.448) .410 .985 −.442 (.446) .321 .734 −.386 (.450) .392 .722 −.380 (.448) .396
Age 1.312 .220 (.192) .252 2.024 .274 (.193) .155 2.098 .283 (.195) .147 1.886 .264 (.192) .170
AdjBMI 2.499 .303 (.192) .114 3.121 .333 (.188) .077 2.298 .290 (.191) .130 2.755 .317 (.191) .097
NA 5.420 .507 (.218) .020* 8.008 .545 (.193) .005** 7.844 .556 (.198) .005** 8.388 .552 (.191) .004**
PA .411 −.138 (.215) .521 .378 −.119 (.193) .539 .464 −.137 (.201) .496 .554 −.145 (.195) .457
Self-regulation 3.801 .437 (.224) .050* .001 .004 (.185) .981 2.568 .309 (.193) .109 .057 .045 (.188) .812
NA × self- 2.274 −.215 (.190) .259 .187 −.081 (.188) .666 4.444 −.372 (.176) .035* 2.766 −.317 (.191) .096
regulation
PA × self-regu- .189 .093 (.214) .664 .015 .024 (.195) .902 .053 −.038 (.165) .818 .205 −.079 (.175) .650
lation
Constant 41.003 −1.563 (.244) .000*** 45.516 −1.545 (.229) .000*** 44.056 −1.538 (.232) .000*** 47.449 −1.573 (.228) .000***
Model test χ2 (8) = 26.198, p = .001** χ2 (8) = 21.413, p = .006** χ2 (8) = 26.312, p = .001** χ2 (8) = 23.250, p = .003**
−2LL (Nagel- 198.669 (.171) 203.454 (.141) 199.349 (.170) 202.412 (.151)
kerke ­R2)

OBE objective binge eating, NA negative affectivity, PA positive affectivity, AdjBMI adjusted body mass index
*p ≤ .050
**p ≤ .010
***p ≤ .001
Each model includes a different aspect of self-regulation:
a
 BRIEF Behavioral Regulation index (adolescent report)
b
 BRIEF Inhibition subscale (adolescent report)
c
 BRIEF Behavioral Regulation index (parent report)
d
 BRIEF Inhibition subscale (parent report)

13

Fig. 1  Interaction between
BEH-P and NA in predicting
the probability of OBE
Probability of OBE
Note. BEH-P = BRIEF Behavioral Regulation index (parent report); NA = Negative Affectivity; OBE = Objective Binge Eating
*
p ≤ .050, ** p ≤ .010, *** p ≤ .001
were in line with expectations based on similar findings in
adolescent samples [2, 17, 18, 42, 43]. The results provide
further evidence for the important roles of both cognitive
(i.e., role of self-regulation; [22]) and affective (i.e., role
of negative affectivity; [38]) perspectives on vulnerability
factors of binge eating in adolescents.
Contrary to expectations, these main effects were
observed only for one type of binge eating, namely OBE.
However, as OBE is recognized by the DSM-5 [57] as the
main symptom of eating disorders such as bulimia nervosa
and binge eating disorder, this specific type of binge eating
episode may be the most clinically relevant and thus the only
one in which the main effects of general self-regulation and
negative affectivity are fully expressed.
It is important to note that our results did not provide evi-
dence for unique effects of inhibitory control, nor for posi-
tive affectivity in predicting binge eating. The lack of a main
effect of inhibitory control is at odds with some previous
studies showing impaired inhibitory control in binge eating
(e.g., [25, 26]), but in line with others that similarly showed
no impairments in this aspect of self-regulation (e.g., [2,
17]). It is important to note that all these studies differed
in the assessment methods they used to capture inhibitory
control (e.g., questionnaires, fMRI, neuropsychological
tasks). Different assessment methods may capture differ-
ent constructs, which may contribute to the mixed results
(e.g., [74, 75]). This highlights the need for future research
to operationalize the construct of inhibitory control not only
using ‘trait-like’ measures of self-regulation in daily life
(e.g., with questionnaires such as the BRIEF) but also with
‘state-like’ measures of self-regulation in a specific situation
(e.g., go/no-go task). The lack of a main effect of positive
affectivity, will be discussed below as this variable did not
independently predict binge eating, but did so in interaction
with self-regulation.
13
European Child & Adolescent Psychiatry
0.5
0.45 Low NA
0.4
0.35 High NA
b = -.152, SE = .231, p = .512
0.3
0.25
0.2
0.15
0.1
b = .781, SE = .334, p = .019
0.05
0
Low BEH-P High BEH-P
The second research question focused on whether and
how self-regulation and affectivity interact to predict LOC,
OBE and SBE. Results revealed a significant interaction
between self-regulation (reported by the parent) and nega-
tive affectivity in predicting OBE. Closer examination of the
nature of this interaction showed that, when negative affec-
tivity was low (i.e., low susceptibility to experience negative
feelings and distress), youngsters with poor self-regulatory
capacities are significantly more at risk of OBE. By con-
trast, youngsters with high negative affectivity (i.e., high
susceptibility to experience negative feelings and distress)
appear to be at greater risk of experiencing OBE independ-
ent of their self-regulatory capacities. This finding high-
lights the importance of high levels of negative affectivity
for predicting OBE, which is in line with the central focus of
the affect regulation model of binge eating [38]. Moreover,
this interaction effect between self-regulation and negative
affectivity seems to suggest that the role of self-regulation
in predicting OBE is subordinate to the role of negative
affectivity, as its detrimental association with binge eating
is expressed only in youngsters with low negative affectiv-
ity. Importantly, this interaction between self-regulation and
negative affectivity was observed only when self-regulation
was reported by the parent. Adolescence can be described
as a turbulent period with numerous challenges, for exam-
ple, attaining increasing independence from parents. This
may result in more frequent parent–child conflicts, which
are often accompanied by high levels of negative affectiv-
ity [76, 77]. Thus, it is possible that adolescents’ negative
affectivity becomes more noticeable or striking to parents in
this age group. Particularly for youngsters with high levels of
negative affectivity, this emotionality may dampen the role
of poor self-regulatory skills in predicting OBE. To explore
this possibility, it is important that self-regulation as well
as affectivity are reported by both the adolescent and the
 Table 3  Logistic regression analysis: self-regulation × affectivity in predicting the probability of SBE
Model ­1a Model ­2b Model ­3c Model ­4d
Wald χ2 B (SE) p Wald χ2 B (SE) p Wald χ2 B (SE) p Wald χ2 B (SE) p
European Child & Adolescent Psychiatry

Covariates
 Gender .004 .023 (.385) .951 .007 −.032 (.386) .934 .003 −.020 (.381) .958 .003 −.023 (.382) .953
 Age 1.036 .187 (.183) .309 .916 .176 (.184) .339 1.160 .197 (.183) .281 1.451 .219 (.182) .228
 AdjBMI .017 −.023 (.178) .896 .002 −.009 (.175) .961 .050 −.040 (.179) .823 .044 −.038 (.179) .833
NA .000 −.002 (.195) .922 .006 −.014 (.184) .939 .094 −.057 (.185) .759 .071 −.047 (.178) .790
PA .484 −.136 (.195) .487 .015 −.023 (.188) .903 .214 −.090 (.183) .623 .081 −.052 (.182) .776
Self-regulation .077 −.056 (.203) .781 .085 −.050 (.173) .771 .114 −.066 (.195) .735 .475 .120 (.175) .491
NA × self- .047 .039 (.181) .828 1.672 −.238 (.184) .196 2.690 −.361 (.220) .101 2.177 −.292 (.198) .140
regulation
PA × self-regu- 4.706 .464 (.214) .030* .015 .023 (.186) .904 .805 −.164 (.182) .370 .746 −.149 (.172) .388
lation
Constant 41.200 −1.443 (.225) .000*** 47.871 −1.460 (.211) .000*** 47.692 −1.446 (.209) .000*** 50.414 −1.471 (.207) .000***
Model test χ2 (8) = 7.522, p = .482 χ2 (8) = 3.860, p = .870 χ2 (8) = 4.912, p = .767 χ2 (8) = 4.492, p = .810
−2LL (Nagel- 221.156 (.050) 224.817 (.026) 227.552 (.033) 227.972 (.030)
kerke ­R2)

SBE subjective binge eating, NA negative affectivity, PA positive affectivity, AdjBMI adjusted body mass index
*p ≤ .050
**p ≤ .010
***p ≤ .001
Each model includes a different aspect of self-regulation:
a
 BRIEF Behavioral Regulation index (adolescent report)
b
 BRIEF Inhibition subscale (adolescent report)
c
 BRIEF Behavioral Regulation index (parent report)
d
 BRIEF Inhibition subscale (parent report)

13

Fig. 2  Interaction between 0.5
BEH-A and PA in predicting the 0.45
probability of SBE
0.4
0.35
Probability of SBE
0.3
0.25
0.2
0.15
0.1
0.05
0
Low BEH-A
Note. BEH-A = BRIEF Behavioral Regulation index (adolescent report); PA = Positive Affectivity; SBE = Subjective Binge Eating
*
p ≤ .050, ** p ≤ .010, *** p ≤ .001
parent. As noted above, when self-regulation was reported
by the adolescents themselves, self-regulation and negative
affectivity each individually predicted OBE, but not in inter-
action. In line with the reasoning above, it may be that both
factors are equally relevant from the adolescents’ perspective
(i.e., main effects), whereas negative affectivity may be more
important than self-regulation from the parents’ perspective
(i.e., interaction effect).
We further found that self-regulation (reported by the
adolescent) interacted with positive affectivity to predict
SBE. Contrary to expectations (e.g., based on [53, 55]), it
was not the combination of poor self-regulatory skills and
low positive affectivity that was associated with the greatest
likelihood of experiencing SBE. Rather, both high and low
levels of positive affectivity were associated with a greater
risk of SBE. In particular, good self-regulatory skills were
associated with a greater risk of SBE when positive affec-
tivity was very low (i.e., very low susceptibility to experi-
ence positive feelings and joy), whereas poor self-regulatory
skills was associated with a greater risk of SBE when posi-
tive affectivity was very high (i.e., very high susceptibility
to experience positive feelings and joy).
Interestingly, the interaction between self-regulation and
positive affectivity produced two ‘vulnerable profiles’ for
experiencing SBE. Because the affect regulation model does
not make specific predictions about the role of positive affec-
tivity in binge eating [38], the current results have impor-
tant added value in showing two possible affect regulatory
pathways for explaining SBE. In the first profile, youngsters
with good self-regulatory skills have a higher probability of
experiencing SBE when they have very low levels of positive
affectivity. Although good self-regulatory skills are gener-
ally considered to be a protective factor in the context of eat-
ing pathology (e.g., [78]), the current results show that these
can have an adverse impact in youngsters with very low
levels of positive affectivity. More specifically, it may be that
13
European Child & Adolescent Psychiatry
Low PA
High PA
b = .408, SE = .267, p = .127
b = -.629, SE = .335, p = .061
High BEH-A
good self-regulatory skills in combination with low positive
affectivity corresponds to the typical profile of unsuccessful
restrained eaters. Restrained eaters often impose strict die-
tary rules but may be perfectly able to regulate themselves
throughout the day. However, in certain circumstances,
they may fail in their attempts for weight control which
may result in experiences of binge eating episodes [79–81].
Results of the present study may add to the understanding
of the circumstances that may cause this breakdown. More
specifically, especially youngsters who are characterized by
low levels of positive affectivity may experience SBE as
a strategy to increase positive affectivity when confronted
with attractive food cues in the environment. Thus, SBE may
function as an emotion regulation strategy to ‘up-regulate’
positive affectivity. This extends the affect regulation model
of binge eating by showing that the positive reinforcement of
binge eating may not only be driven by decreased levels of
negative affectivity but also by increased levels of positive
affectivity [38].
In the second profile, youngsters with poor self-regula-
tory skills have a higher probability of experiencing SBE
when they have very high levels of positive affectivity.
Similar to self-regulation, positive affectivity has also been
described as a protective factor in adolescents’ development
(e.g., [46]); however, the present results reveal detrimental
effects of very high levels of positive affectivity in combi-
nation with poor self-regulatory skills. Previous findings in
the temperament literature may help to explain this result.
More specifically, Rothbart et al. [33] stated that high levels
of positive affectivity are a reflection of high positive emo-
tional reactivity to the environment, which places additional
demands on self-regulatory capacities. In the current study,
adolescents may find it difficult to lower their high positive
emotional reactivity due to their poor self-regulatory skills,
whereby SBE functions as an emotion regulation strategy
to ‘down-regulate’ positive affectivity. The potential risk
European Child & Adolescent Psychiatry
of high levels of positive affectivity has similarly been
acknowledged in the eating disorders domain (e.g., [82,
83]). Especially, Haynos et al. [84] examined the effect of
positive affectivity across different types of eating disorders.
They found that the role of high positive affectivity was par-
ticularly relevant for individuals with anorexia nervosa of
the binge–purge type, in which SBE may be a core symp-
tom [57, 85]. Although the focus of previous research in the
binge eating domain has been predominantly on LOC and/or
OBE, the present findings strengthen the relevance of poor
self-regulatory skills in combination with very high levels of
positive affectivity specifically in predicting SBE. Moreover,
as this interaction between self-regulation and positive affec-
tivity was found only when adolescents themselves reported
on their self-regulatory skills, it emphasizes the subjective
experience of SBE.
To summarize, self-regulation and affectivity both play
unique and combined roles in predicting OBE and SBE.
Although LOC is inherent in both types of binge eating, no
significant effects were found for LOC. As demonstrated by
the current findings, there appears to be a substantial differ-
ence in the underlying vulnerability patterns for OBE and
SBE, which may have obviated any effects for LOC.
Strengths and limitations
The current study has several strengths. First, it sought to
gain further insight into the complex reality of binge eat-
ing by considering different types of risk factors (i.e., self-
regulation and affectivity), both individually and in interac-
tion with each other. As research has previously documented
important differences between different types of binge eat-
ing episodes [12], three types of episodes (i.e., OBE, SBE
and LOC) were included as outcome variables. Second,
we recruited a large sample of 301 adolescents from the
general community (10–17 years old). This age group is of
particular significance, as adolescence has been found to be
a risk period for developing eating problems such as binge
eating [4]. Third, the self-regulatory skills of adolescents
were assessed by the adolescents themselves as well as their
parents (i.e., multi-informant). Finally, the current study
extends on previous research based on the affect regulation
model by including not only negative affectivity but also
positive affectivity [38]. In doing so, the role of affectivity in
the context of binge eating in adolescents could be examined
more comprehensively.
The current study also has some limitations that need to
be acknowledged. While the chosen data analytic technique
could test the probability of binge eating given a specific
set of independent variables, the cross-sectional design of
the study means that we cannot draw inferences about the
predictive role of self-regulation and affectivity in binge eat-
ing, nor can we conclude about causality. In addition, the
present design did not allow us to test whether these risk
factors also serve an important role in predicting the sever-
ity of binge eating. Longitudinal and experimental designs
in samples with more individuals experiencing a broader
range of binge eating episodes (e.g., subclinical or clinical
samples) are therefore needed. Furthermore, we exclusively
used questionnaires to operationalize all variables. To over-
come the possible mono-method bias in results [86], it is
important that the current findings are replicated with dif-
ferent assessment methods (e.g., behavioral tasks for self-
regulation, experimental mood induction).
Implications
The current study has some important theoretical and practi-
cal implications. First, the results provide further evidence
for the role of self-regulatory problems as a risk factor for
binge eating [2, 18]. Because this points to a general contri-
bution of self-regulation, and because the role of inhibitory
control is still unclear, future research will need to disentan-
gle the underlying factors of this umbrella term. In doing so,
it is important that not only inhibitory control is examined
but also other cognitive aspects of self-regulation (e.g., cog-
nitive flexibility, working memory) and that a combination
of various assessment methods (e.g., questionnaires and
behavioral tasks) will be used to measure these constructs
[87]. Second, the present results provide further insight into
the affect regulation model of binge eating by examining
both positive and negative affectivity in binge eating. More
specifically, results seem to indicate that binge eating may
serve as an emotion regulation strategy to regulate levels
of negative or positive affectivity. While previous research
found that OBE was most associated with eating-related
distress, whereas SBE was indicative for mood-related psy-
chopathology [10–12], the present study showed preliminary
evidence for the role of trait affectivity in both types of binge
eating episodes. Specifically, the results seem to suggest that
negative affectivity may be relevant in explaining OBE,
while positive affectivity seems to be more important in
the context of SBE. Importantly, the current study assessed
these concepts as traits through the use of questionnaires.
Thus, future research endeavoring to replicate the current
findings with, for example, an experimental mood induction
design to measure state affectivity will be necessary.
Knowledge derived from research that focuses on clarify-
ing the roles of self-regulation and affectivity can be used
to refine theoretical models about the development and
maintenance of eating problems in youth. Such models can
provide a starting point for setting up screening programs
to identify high-risk populations. The results of the present
study demonstrate that there may be several important points
to consider in such screening. In particular, the differen-
tiation of types of binge eating seems important, because
13

different types are associated with (a combination of) dif-
ferent explanatory factors. Both self-regulation and affectiv-
ity seem to be important adolescent characteristics to take
into account while screening for binge eating, and their role
seems to depend on the type of binge eating (e.g., negative
affectivity for OBE, positive affectivity for SBE) and the
informant.
10. Fitzsimmons-Craft EE et al (2014) Subjective and objective binge
Conclusion
In conclusion, the current study provides evidence for the
importance of cognitive as well as affective perspectives
on binge eating. Specifically, self-regulation and affectivity
both play unique and combined roles in predicting binge
eating. However, results largely depended on the type of
binge eating and the informant. For OBE, main effects of
self-regulation (adolescent report) and negative affectivity
were found, as well as an interaction between self-regulation
(parent report) and negative affectivity. For SBE, however,
only an interaction effect between self-regulation (adolescent
report) and positive affectivity was observed. Replication
of these findings with different assessment methods and
designs is warranted.
Author contributions  LG, EK and EVM designed the study and wrote
the protocol. EVM and EB were responsible for the data collection,
under supervision of LG. EVM conducted the statistical analyses and
wrote the first draft of the manuscript. All other authors edited subse-
quent drafts of the manuscript, and have approved the final manuscript.
Funding  The research was supported by the Special Research Fund of
Ghent University. The funding body had no role in the study design,
collection, analysis or interpretation of the data, writing of the manu-
script, or decision to submit the manuscript for publication.
Compliance with ethical standards  chol 75(6):901
Conflict of interest  On behalf of all authors, the corresponding author
states that there is no conflict of interest.
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